Walking as a Mediator Between Strength and Health-Related Quality of Life in Multiple Sclerosis
Background and Purpose: Lower limb (LL) weakness and gait impairment are prevalent among persons with multiple sclerosis (PwMS) and can impede functional independence and impact health-related quality of life (HR-QoL). The purpose of this study was to examine the mediation effect of walking speed and perceived walking ability on the relationship between LL weakness and HR-QoL in ambulatory PwMS.
Proximal Muscle Resistance Training to Improve Walking in People With Multiple Sclerosis: A Pilot Study
This pilot study examined the feasibility of a proximal muscle resistance training program to improve walking in people with multiple sclerosis using a combination of in-person, virtual, and independent exercise sessions.
Vagus Nerve Stimulation Paired With Rehabilitation for Chronic Stroke: Characterizing Responders
Implantable vagus nerve stimulation (VNS) paired with volitional upper extremity rehabilitation can improve impairment and function among moderately to severely impaired, chronic stroke survivors. This study is a retrospective analysis of the in-clinic rehabilitation phase of the blinded, placebo-controlled, randomized pivotal VNS-REHAB trial to determine whether dosing parameters during in-clinic paired VNS therapy were associated with responder status and whether covariates might impact that determination.
Motor and Non-Motor Factors of Concern About Falling and Fear of Falling in Multiple Sclerosis
Despite the frequency of concern about falling (CAF) and fear of falling (FOF) in multiple sclerosis (MS), there remains a lack of clarity between FOF and CAF, though persons with MS have indicated that CAF and FOF are distinct constructs. Our team previously developed and validated a new questionnaire, the Concern and Fear of Falling Evaluation (CAFFE), to assess these concepts. This study aimed to examine CAF and FOF prevalence, and determine relationships among CAF, FOF, and self-reported motor, cognitive, and psychological function in MS relapsing (RRMS) and progressive (PMS) subtypes.
The Role of the Cervical Spine in Dizziness
The neck can be implicated in dizziness via several, separate, discreet mechanisms. Proprioceptive cervicogenic dizziness (CGD) is the most common and reflects the cervical spine's important role, along with visual and vestibular input, for sensorimotor control. Impaired cervical proprioception can lead to symptoms such as dizziness, unsteadiness, visual disturbances, and altered sensorimotor control, and treatment directed toward cervical musculoskeletal and sensorimotor control is efficacious to improve this in individuals with cervical musculoskeletal disorders. Despite this, CGD is difficult to diagnose. Many people present with both neck pain and dizziness, and often the onset of both follows head and neck trauma, but neither necessarily implicate the neck as the cause of dizziness. Further, people often present with mixed forms of dizziness. Thus, rather than diagnosing CGD, it might be more important to consider the potential for the neck to have no (nil, co-morbid cervical condition) or some (minor, major, or compensatory) role in dizziness. Determining the precise role of the cervical spine role in dizziness requires a skilled interview and examination for cervical musculoskeletal and related sensorimotor impairments and relevant testing of other potential causes. A combination and cluster of test outcomes in addition to comparing responses to specific tests when the cervical afferents are stimulated and not stimulated will be important. Considering the role of the neck in dizziness will allow a balanced approach in assessment and management to allow timely, effective intervention to be provided to the large number of individuals presenting with neck pain and dizziness (Supplemental Digital Content, available at: http://links.lww.com/JNPT/A484 ).
Improving Executive Function and Dual-Task Cost in Parkinson Disease: A Randomized Controlled Trial
Dual-task walking is challenging for people with Parkinson disease (PD). Gait performance worsens while executing dual tasks, possibly due to a decline in executive function (EF). This study aimed to investigate the effects of dual-task training on EF and dual-task cost (DTC) in people with PD and to explore whether training-induced changes in EF were associated with changes in DTC.
Measuring Exercise Self-Efficacy After Stroke: Validity and Reliability of Current Measures
Many physically capable stroke survivors are insufficiently active, with low self-efficacy considered an important contributor. However, validity and reliability of self-efficacy measures in stroke survivors have not been established. This research aims to evaluate the test-retest reliability and construct validity of 3 self-efficacy measures: Self-Efficacy for Exercise Scale (SEE), Spinal Cord Injury Exercise Self-Efficacy Scale (SCI-ESES), and Participation Strategies Self-Efficacy Scale (PS-SES).
Sensory Stimulation and Robot-Assisted Arm Training After Stroke: A Randomized Controlled Trial
Functional recovery after stroke is often limited, despite various treatment methods such as robot-assisted therapy. Repetitive sensory stimulation (RSS) might be a promising add-on therapy that is thought to directly drive plasticity processes. First positive effects on sensorimotor function have been shown. However, clinical studies are scarce, and the effect of RSS combined with robot-assisted training has not been evaluated yet. Therefore, our objective was to investigate the feasibility and sensorimotor effects of RSS (compared to a control group receiving sham stimulation) followed by robot-assisted arm therapy.
Visuospatial Skills Explain Differences in the Ability to Use Propulsion Biofeedback Post-stroke
Visual biofeedback can be used to help people post-stroke reduce biomechanical gait impairments. Using visual biofeedback engages an explicit, cognitively demanding motor learning process. Participants with better overall cognitive function are better able to use visual biofeedback to promote locomotor learning; however, which specific cognitive domains are responsible for this effect are unknown. We aimed to understand which cognitive domains were associated with performance during acquisition and immediate retention when using visual biofeedback to increase paretic propulsion in individuals post-stroke.
Implementation and Clinical Outcomes of Blood Flow Restriction Training on Adults With Cerebral Palsy: A Case Series
Cerebral palsy (CP) is a congenital neurological disorder that causes musculoskeletal weakness and biomechanical dysfunctions. Strength training guidelines recommend at least 70% of 1-repetition maximum to increase muscle strength and mass. However, individuals with CP may not tolerate such high exercise intensity. Blood flow restriction (BFR) can induce similar gains in strength and muscle mass using loads as low as 20% to 30% 1-repetition maximum. This case series described the safety, feasibility, and acceptability of BFR in adults with CP and examined changes in muscle mass and strength.
Generalization of In-Place Balance Perturbation Training in People With Parkinson Disease
Reactive balance training improves reactive postural control in people with Parkinson disease (PwPD). However, the extent to which reactive balance training generalizes to a novel, unpracticed reactive balance task is unknown. This study aimed to determine whether reactive training stepping through support surface translations can be generalized to an unpracticed, instrumented tether-release task.
Bicycling for Rehabilitation of Persons With Parkinson Disease: A Scoping Review
Exercise is beneficial for persons with Parkinson disease (PwPD). The overarching purpose of this scoping review was to provide guidance to clinicians and scientists regarding current evidence for bicycling exercise for PwPD. A scoping review was conducted to examine the heterogeneous literature on stationary bicycling for PwPD to reduce motor symptoms and body function structure impairments, improve activities and motor performance, and reduce disease severity.
Neural Mechanisms Associated With Postural Control in Collegiate Soccer and Non-Soccer Athletes
Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error Scoring System (BESS) is related to white matter organization (WMO) in collegiate athletes.
Examining Sex Differences in Relationships Between Subjective and Objective Measures of Upper Extremity Motor Impairment in a Sample of Stroke Survivors
Rehabilitation professionals use subjective and objective outcome measures to assess stroke-related impact and impairment. Understanding if subjective and objective findings correlate among stroke survivors, especially if these associations differ between females and males, can inform care decisions.
Commentary on: "Generalization of In-Place Balance Perturbation Training in People With Parkinson Disease"
Physical Therapy and Aminopyridine for Downbeat Nystagmus Syndrome: A Case Report
Individuals with downbeat nystagmus (DBN) syndrome present with DBN, dizziness, blurred vision, and unsteady gait. Pharmacological intervention with 4-aminopyridine (4-AP) may be effective in improving oculomotor function, but there is minimal evidence to date that it improves gait. This suggests the possible benefit of combining pharmacotherapy with physical therapy to maximize outcomes. This case report documents improvements in gait and balance after physical therapy and aminopyridine (AP) in an individual with DBN syndrome.
Fatigue Is Associated With Perceived Effort and 2-Dimensional Reach Performance After Stroke
Poststroke fatigue (PSF) is prevalent and often manifests as high perceived effort during activities. Little is known about how PSF influences goal-directed reaching after stroke. The purpose of this study was 2-fold (1) to evaluate how perceived effort changed when individuals with stroke performed a reaching task with various demands and (2) to determine whether PSF was associated with perceived effort during reaching and reach performance.
Feasibility of a Recumbent Stepper for Short-Interval, Low-Volume High-Intensity Interval Exercise in Stroke
Studies investigating high-intensity interval exercise (HIIE) in stroke typically emphasize treadmill training. However, a literature review suggested that seated devices such as a recumbent stepper or cycle offer a promising alternative for HIIE since exercise can be prescribed using peak power output (PPO). Therefore, this would give health care professionals the ability to monitor and adapt power output for the target heart rate range. The purpose of this secondary analysis was to examine the feasibility of prescribing short-interval, low-volume HIIE using PPO in chronic stroke.
Use of a Robotic Walking Device for Home and Community Mobility in Parkinson Disease: A Randomized Controlled Trial
Gait impairments in Parkinson disease (PD) contribute to decreased quality of life. This randomized controlled trial examined immediate- and longer-term effects of a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device, on gait.
Improvement in the Capacity for Activity versus Improvement in Performance of Activity in Daily Life during Outpatient Rehabilitation: Erratum
Recognizing the Most Outstanding 2023 Article Published in the JNPT